Organization
KEY WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY M VANVICKLE CNP (CO-OWNER)
(218) 692-5397
Entity
Organization
Contact information
Practice address
35752 ALLEN AVE, CROSSLAKE, MN 56442-5502
(218) 513-4072
Mailing address
PO BOX 65, CROSSLAKE, MN 56442-0065
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/27/2021
Last updated
09/16/2021
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